Goal: To compare efficacy of 1) a group focused manualized vocational program (MVP) intervention versus 2) a group focused manualized vocational program plus enhancement using supportive employment (MVPSE). The focus of the grant is assisting veterans with histories of felonies who have mental health and/or substance dependence in obtaining and maintaining employment. A subgoal will be the assessment of the effect of the programs on homelessness and re-arrests. Summary: With over 63,000 incarcerated veterans being released from prisons and jails annually, there is a critical need to improve vocational services for those with histories of felony convictions. Statistics indicate that 67% will be re-arrested and 57% will return to prison within three years (e.g. Langan &Levin, 2002;LaVigne &Kachnowski, 2005). One of the strongest factors in re-arrests and overall quality of life is employment. However, on any given day 45% of those with felony histories are unemployed. These veterans have significant psychosocial stressors. Veterans with a long-term incarceration history had higher levels of psychiatric problems, drug use, and alcohol use using the Addiction Severity Index as well as higher rates of dual diagnosis than those with a short-term incarceration history or those with no history of incarceration (McGuire &Rosenheck, 2004). Additionally, there is a high level of co-occurrence between incarceration and homelessness. Though the number of veterans in need is large and the potential benefit great, there is a significant need for techniques and programs that assist these veterans in returning to work. One area that has proven successful in assisting vulnerable populations in obtaining and sustaining employment is Supportive Employment (e.g. Becker &Drake, 2006;Bond, 2004). Supportive Employment provides ongoing assistance in developing jobs, obtaining employment, support during employment, and coordination with other psychosocial needs. This study will seek to improve on the findings from RR&D Grant D6192-R "Evaluating Vocational Materials for Incarcerated Veterans with MI [mental illness] or SA [substance abuse/dependence]" by testing the incorporation of supportive employment into a proven manualized treatment program. It is expected findings will serve to improve functioning and quality of life of mentally ill and/or substance dependent veterans (a VA Rehab R&D priority area) with felony convictions. Our goal is to compare an established manualized vocational reintegration program to the manualized program plus services based on the principles of supported employment to determine whether supported employment can improve on job success rates. 192 veterans will be randomly assigned to one of two conditions: 1) a manual based class led by trained vocational staff;or 2) a manual based class led by trained vocational staff plus individual services based on the principles of and techniques use by supported employment (e.g. sustained support past obtaining employment, job development, job coaching, community engagement, rapid progression to job search, etc.). Veterans will be followed for 24 months.
Specific Aims 1) Test time to employment and time to stable employment between the MVP and MVPSE 2) To compare total time employed between MVP and MVPSE over the 24 months following training period 3) Identify differences in rates of homelessness and re-arrests between those in the MVP condition compared to the MVPSE condition

Public Health Relevance

This study continues to develop and refine best practices in the delivery of vocational services to veterans with histories of felony convictions and mental health/substance abuse difficulties. There are currently over 225,000 incarcerated veterans and it is estimated 64,000 veterans are released from prisons annually. These veterans encounter significant difficulties in finding employment due to stigma, intrapersonal difficulties, and out-dated work skills. Additionally these veterans are more likely to be homeless than other population., Previous work has found that manual based, vocational groups led by trained vocational staff led to quicker employment compared to traditional vocational services and manual based self studies. To attempt to improve on previous results, this study adds principles and components of supported employment including ongoing follow-up, treatment team coordination, and community based assistance.

Agency
National Institute of Health (NIH)
Type
Non-HHS Research Projects (I01)
Project #
5I01RX000484-03
Application #
8838163
Study Section
Psychological Health &Social Reintegration (RRD4)
Project Start
Project End
Budget Start
Budget End
Support Year
3
Fiscal Year
2014
Total Cost
Indirect Cost
Name
VA North Texas Health Care System
Department
Type
DUNS #
City
Dallas
State
TX
Country
United States
Zip Code
75216